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Investigation of an association between onset of narcolepsy and vaccination with pandemic influenza vaccine, Ireland April 2009-December 2010.
Euro Surveill. 2014 May 01; 19(17):15-25.ES

Abstract

In 2011, the Irish Medicines Board received reports of onset of narcolepsy following vaccination against influenza A(H1N1)pdm09 with Pandemrix. A national steering committee was convened to examine the association between narcolepsy and pandemic vaccination. We conducted a retrospective population-based cohort study. Narcolepsy cases with onset from 1 April 2009 to 31 December 2010 were identified through active case finding. Narcolepsy history was gathered from medical records. Pandemic vaccination status was obtained from vaccination databases. Two independent experts classified cases using the Brighton case definition. Date of onset was defined as date of first healthcare contact for narcolepsy symptoms. Incidence of narcolepsy in vaccinated and non-vaccinated individuals was compared. Of 32 narcolepsy cases identified, 28 occurred in children/adolescents and for 24 first healthcare contact was between April 2009 and December 2010. Narcolepsy incidence was 5.7 (95% confidence interval (CI): 3.4–8.9) per 100,000 children/adolescents vaccinated with Pandemrix and 0.4 (95% CI: 0.1–1.0) per 100,000 unvaccinated children/adolescents (relative risk: 13.9; absolute attributable risk: 5.3 cases per 100,000 vaccinated children/adolescents). This study confirms the crude association between Pandemrix vaccination and narcolepsy as observed in Finland and Sweden. The vaccine is no longer in use in Ireland. Further studies are needed to explore the immunogenetic mechanism of narcolepsy.

Authors+Show Affiliations

Health Service Executive, Health Protection Surveillance Centre, Dublin, Ireland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

24821121

Citation

O'Flanagan, D, et al. "Investigation of an Association Between Onset of Narcolepsy and Vaccination With Pandemic Influenza Vaccine, Ireland April 2009-December 2010." Euro Surveillance : Bulletin Europeen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin, vol. 19, no. 17, 2014, pp. 15-25.
O'Flanagan D, Barret AS, Foley M, et al. Investigation of an association between onset of narcolepsy and vaccination with pandemic influenza vaccine, Ireland April 2009-December 2010. Euro Surveill. 2014;19(17):15-25.
O'Flanagan, D., Barret, A. S., Foley, M., Cotter, S., Bonner, C., Crowe, C., Lynch, B., Sweeney, B., Johnson, H., McCoy, B., & Purcell, E. (2014). Investigation of an association between onset of narcolepsy and vaccination with pandemic influenza vaccine, Ireland April 2009-December 2010. Euro Surveillance : Bulletin Europeen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin, 19(17), 15-25.
O'Flanagan D, et al. Investigation of an Association Between Onset of Narcolepsy and Vaccination With Pandemic Influenza Vaccine, Ireland April 2009-December 2010. Euro Surveill. 2014 May 1;19(17):15-25. PubMed PMID: 24821121.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Investigation of an association between onset of narcolepsy and vaccination with pandemic influenza vaccine, Ireland April 2009-December 2010. AU - O'Flanagan,D, AU - Barret,A S, AU - Foley,M, AU - Cotter,S, AU - Bonner,C, AU - Crowe,C, AU - Lynch,B, AU - Sweeney,B, AU - Johnson,H, AU - McCoy,B, AU - Purcell,E, Y1 - 2014/05/01/ PY - 2014/5/14/entrez PY - 2014/5/14/pubmed PY - 2014/8/13/medline SP - 15 EP - 25 JF - Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin JO - Euro Surveill VL - 19 IS - 17 N2 - In 2011, the Irish Medicines Board received reports of onset of narcolepsy following vaccination against influenza A(H1N1)pdm09 with Pandemrix. A national steering committee was convened to examine the association between narcolepsy and pandemic vaccination. We conducted a retrospective population-based cohort study. Narcolepsy cases with onset from 1 April 2009 to 31 December 2010 were identified through active case finding. Narcolepsy history was gathered from medical records. Pandemic vaccination status was obtained from vaccination databases. Two independent experts classified cases using the Brighton case definition. Date of onset was defined as date of first healthcare contact for narcolepsy symptoms. Incidence of narcolepsy in vaccinated and non-vaccinated individuals was compared. Of 32 narcolepsy cases identified, 28 occurred in children/adolescents and for 24 first healthcare contact was between April 2009 and December 2010. Narcolepsy incidence was 5.7 (95% confidence interval (CI): 3.4–8.9) per 100,000 children/adolescents vaccinated with Pandemrix and 0.4 (95% CI: 0.1–1.0) per 100,000 unvaccinated children/adolescents (relative risk: 13.9; absolute attributable risk: 5.3 cases per 100,000 vaccinated children/adolescents). This study confirms the crude association between Pandemrix vaccination and narcolepsy as observed in Finland and Sweden. The vaccine is no longer in use in Ireland. Further studies are needed to explore the immunogenetic mechanism of narcolepsy. SN - 1560-7917 UR - https://www.unboundmedicine.com/medline/citation/24821121/Investigation_of_an_association_between_onset_of_narcolepsy_and_vaccination_with_pandemic_influenza_vaccine_Ireland_April_2009_December_2010_ L2 - http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20789 DB - PRIME DP - Unbound Medicine ER -